Select your program below by checking the appropriate boxes. Circle the amount(s) in the applicable date column
and figure the total amount. Be sure to check the refundable deposit box (a registration requirement), credit transaction
fees and discount box, if applicable. Only registrations accompanied by full payment will be processed.
Postmark or time of electronic registration shall determine the date of registration. Please attach a copy of your current medical license. A
photocopy or faxed copy of this form is acceptable, but signature must be included. Fees include certain supplies
and instructional materials. Please keep a copy for your records.

Acupuncture Course

Before 2/15

Before 3/15

After 3/15

Core Curriculum: Phase 1, Phase 2, Phase 3(330 hours)

$8,800

$9,100

$9,500

Phase 1 and 3, online home study only # (226 hours)

$4,950

$5,150

$5,350

*Refundable deposit for registrants staying at the conference hotel throughout Phase 2 (10 days),
non-refundable for those who do not use the sleeping room block*

$600

$600

$600

Credit Transaction fees (not applicable if paid by check)

$180

$180

$180

Herbal Medicine Course

Before 2/15

Before 3/15

After 3/15

Full Course: Stage A, B, C (280 hours)

$5,500

$5,800

$6,200

Herbal Medicine Course discount for former or current participants of core curriculum of Acupuncture Course

$(400)

$(400)

$(400)

*Refundable deposit for registrants staying at the
conference hotel throughout Stage B (6 days), non-refundable for those who do not use the sleeping room block*

$360

$360

$360

Credit Transaction fees (not applicable if paid by check)

$120

$120

$120

Acupuncture Course framable certificate**

$70

$70

$70

Herbal Medicine Course framable certificate**

$70

$70

$70

Total

*There will be a facility charge of $60 per day per registrant for those who elect not
to stay at the
conference hotel utilizing Academy of Pain Research's room-blocks or share room with another registrant during Acupuncture Course
Phase 2 (7/18 - 7/28/19) or Herbal Course Stage B (9/20 - 9/26/19).